Risk factors for extended-spectrum beta-lactamase-producing Enterobacteriales infection: are they the same in neutropenic and non-neutropenic patients?

Excerpt

Febrile neutropenia (FN) is one of the most frequent and serious complications of chemotherapy for cancer. Neutropenia is defined by an abnormal reduction of neutrophils usually within 7–12 days after chemotherapy. According to the European Society for Medical Oncology (ESMO), FN is defined as “an oral temperature of > 38.3 °C or two consecutive readings of > 38.0 °C for 2 h and an absolute neutrophil count (ANC) of < 0.5 × 10⁹/L, or expected to fall below 0.5 × 10⁹/L” [1]. Neutropenic patients may be less capable of fighting infections due to the reduced levels of neutrophils in circulation.  In patients with FN, the prognosis is worst in case of proven bacteremia, with mortality rates of 18% in Gram-negative and 5% in Gram-positive bacteremia [2]. During the last decade, the global increase in the prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriales has also affected immunocompromised patients [3]. ESBLs can hydrolyze many beta-lactams except for carbapenems and oxyimino-monobactam, so making bacteria resistant in particular to broad-spectrum cephalosporins. …